Medical Insurance.... who for?

Recently a staff member's parents fell ill. This staff member has been with me for many years and over these years she and her family have moved up the social ladder slowly but steadily and are now what one would call a lower middle class family. They still live in the same 'house', but this house has been spruced up and extended. The children attend a good public school and the family's life has changed in more ways than one be it the food they eat or the clothes they wear. I think their wardrobe is larger than mine! Gadgets have found their way in the home and from survival mode they have moved on to urban living mode and are empowered.

When you move up the social ladder you feel compelled to give up certain things that you had accepted for long and that is medical facilities. 10 years back they went to the local quacks when they were ill or doctors who are not really doctors but glorified compounders. There is even one whose boards states that he was trained in Vienna! When your were truly unwell, then you strutted to the closest government hospital.  Strangely or perhaps this is part of the social mobility, the first thing they lose faith in  are state run hospitals, even the ones I would prefer if I had the right contact, and rush to private hospitals that are expensive and with poor medical ethics if any. In this case they shelled out more than 100 000 rupees for the both parents! They did not have any medical insurance.

But let us talk about this new kid on the block: medical insurance! If you pause and think you will realise that  medical insurance covers only hospital stay. Now I cannot state a figure but based on my life I thing we as a family have not been admitted for more than 30 days in the last 40 years in a hospital. Papa, being a Freemason, went to their clinic for his tests and spent 9 days in hospital for his cancer surgery. Mama never went to hospitals and anyway in those time there were very few private hospitals and nursing homes. Having a dear friend in AIIMS, my parents had access to the best. Papa being a government servant could have used the Wellington hospital but never did. This was in the seventies and eighties. I spent 10 days in hospital for the delivery of my two girls. So the need of hospitalisation is very minute. But what we spend on are doctor's visits, occasional blood tests and other medical investigations and medicines. And as we all know this is a substantial amount. Every visit to the doctor plus medicines cost a bomb that no insurance pays.

So who does this great new private insurance truly benefit! Certainly not the patient. Private insurances benefit the big medical business and fraternity. Have you seen how many new fancy hospitals are mushrooming each and every day! I am astounded! Once you cross the threshold of any of these fancy portals, you are drawn into an infernal spiral. Now let us do some maths! let us say you have a 600 000 insurance cover that you pay 15 000 rs per year and you never get hospitalised, then it is sound business! I wonder what the percentage is! Should you get admitted then everything is done to hold on to you and inflate the bill. My cousin brother was according to me DOA after a huge heat attack but was kept 'alive' and multiple surgeries performed on him. He was declared dead the next morning and strangely the bill handed to us was very close to his insurance cover. There was a client who would not get back so let us make the max we can!

So medical insurances cover only hospital stay. That is how it goes. I am sure more doctors are recommending hospitalisation! But today I could not repress a smile when I read a news headlineInsurers in spot as medical advances push up treatment costs! The once quite lucrative business seemed to be taking a beating as new and expensive techniques were available and as the patient did not pay from his pocket he sought the best provided it fell within his insurance. If I am insured for 6 lacs, then why should I take the 70 000 option, I will go for the 3 lac one! But as is said in the article, the insurers are now plotting ways to limit their costs. As I said it is all a matter of making money, who cares about the patient!